Background: Pyogenic vertebral osteomyelitis (VO) represents a clinical
challenge and is linked to substantial morbidity and mortality. This study aimed
to examine mortality as well as potential risk factors contributing to in-hospital
mortality among patients with VO.
Methods: This retrospective analysis involved patients receiving treatment for VO
at University Regensburg in Germany from January 1, 2000, to December 3,
2020. It included in-hospital mortality rate, comorbidities and pathogens.
Patients were identified using ICD-10 diagnosis codes: M46.2, M46.3, M46.4,
and M46.5. Kaplan–Meier probability plots and odds ratios (OR) for mortality
were calculated.
Results: Out of the total cohort of 155 patients with VO, 53 patients (34.1%) died
during a mean follow-up time of 87.8 ± 70.8 months. The overall mortality was
17.2% at one year, 19.9% at two years and 28.3% at five years. Patients with
congestive heart failure (p = 0.005), renal disease (p < 0.001), symptoms of
paraplegia (p = 0.029), and sepsis (p = 0.006) demonstrated significantly
higher overall mortality rates. In 56.1% of cases, pathogens were identified,
with Staphylococcus aureus (S. aureus) and other unidentified pathogens
being the most common. Renal disease (OR 1.85) and congestive heart failure
(OR 1.52) were identified as significant risk factors.
Conclusion: Early assessment of the specific risk factors for each patient may
prove beneficial in the management and treatment of VO to reduce the risk of
mortality. These findings demonstrate the importance of close monitoring of
VO patients with underlying chronic organ disease and early identification and
treatment of sepsis. Prioritizing identification of the exact pathogens and antibiotic
sensitivity testing can improve outcomes for patients in this high-risk group.